Progression of MRI abnormalities in herpes simplex encephalitis despite clinical improvement: natural history or disease progression?

Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
P GavianiF Monaco

Abstract

Herpes simplex virus encephalitis (HSVE) is associated with a high mortality rate and a high probability of neurological sequelae. Good results are obtained when HSVE is promptly diagnosed and treated with acyclovir. We present a 71-year-old woman with clinically diagnosed HSVE, confirmed by PCR detection of HSV-1 DNA in the cerebrospinal fluid. She was treated with acyclovir (30 mg/kg day) for two weeks. Clinical and neuropsychological assessments 6 months after admission were normal; however MRI at 2, 6 and 12 months showed progressive deterioration with extensive white matter and cortical damage. Imaging studies of a cohort of patients surviving PCR-confirmed HSVE are needed to determine whether this pattern is occasional or a frequent form of progression.

Citations

Oct 13, 2006·Molecular Psychiatry·K M R PrasadV L Nimgaonkar
Feb 25, 2010·Journal of Child Neurology·William D BrownJohn E Donahue
Mar 23, 2010·Pediatric Neurology·Galen N Breningstall, Richard J Patterson
Feb 19, 2008·Pediatric Neurology·Tomonari AwayaTatsutoshi Nakahata
Jul 11, 2009·The Neurologist·Sofia MarkoulaAthanassios P Kyritsis
Dec 13, 2005·Topics in Magnetic Resonance Imaging : TMRI·Claudia LeiteLeandro T Lucato

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